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Ms. Stacey Marie Wallace
Specialist in Fredonia, New York
NPI 1700149838

Stacey Marie Wallace is a Specialist based in Fredonia, NY. Stacey Marie Wallace practices in Fredonia, NY. The NPI Number for Stacey Marie Wallace is 1700149838 and holds a License No. 374992091 (New York).

The current practice location address for Stacey Marie Wallace is 75 Chestnut St, Fredonia, NY and can be reached out via phone at 716-672-2731.

Location: 75 Chestnut St, Fredonia, NY, 14063-0311
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700149838
Provider Name
Stacey Marie Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
75 Chestnut St, Fredonia, NY, 14063-0311
Phone Number
716-672-2731
Fax Number
Provider Enumeration Date
06/22/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
75 Chestnut St
City
Fredonia
State
New York
Zip
14063-1630
Phone Number
716-672-2731
Fax Number
person
Provider Business Mailing Address Details
Address
75 Chestnut St
City
Fredonia
State
New York
Zip
14063-1630
Phone Number
716-672-2731
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
374992091 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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